title: Comparative survival following different treatment modalities for stage T2 bladder cancer in octogenarians.
abstract: OBJECTIVE
  A higher rate of comorbidities and an anticipated higher operative risk in octogenarians may influence urologists in opting for less aggressive and less effective treatment modalities for muscle-invasive bladder cancer. This study was performed to compare survival after different treatment modalities in octogenarians with stage T2 bladder cancer.
  
  
  METHODS
  Patients that were 80 years or older with a diagnosis of transitional cell carcinoma of the bladder were identified using the Surveillance, Epidemiology, and End Results-17 registry database between 1988 and 2007. Patients were analyzed for treatment method and outcomes, including overall survival (OS) and cancer-specific survival (CSS).
  
  
  RESULTS
  A total of 3,232 patients met inclusion criteria. Of these, 69 % (N = 2,216) underwent only transurethral resection (TURBT), 23 % (N = 733) underwent pelvic radiation therapy (RT), and 9 % (N = 283) underwent definitive surgical therapy. The 3-, 5-, and 10-year OS rates were 22.2, 15.0, and 4.4 %, respectively, for TURBT; 27.8, 18.3, and 3.5 % for RT; and 52.7, 39.1, and 17.2 % for definitive surgery. The 3-, 5-, and 10-year CSS rates were 38.3, 33.4, and 27.4 %, respectively, for TURBT; 41.6, 35.0, and 27.2 % for RT; and 66.6, 55.5, and 49.9 % for definitive surgery. Both partial and radical cystectomy had significantly longer CSS rates at 3 and 5 years when compared to RT (p ≤ 0.001).
  
  
  CONCLUSIONS
  Compared to other treatment modalities, surgery, either radical cystectomy or partial cystectomy, offers the best OS and CSS for men aged 80 years or older with T2 bladder cancer.
authors.affiliation: Division of Urology, University of Missouri-Columbia School of Medicine, 1 Hospital Drive, Columbia, MO, 65203, USA.
authors.forename: Jerry J
authors.initials: JJ
authors.lastname: Trulson
authors.forename: Pranav
authors.initials: P
authors.lastname: Sharma
authors.forename: Tyler
authors.initials: T
authors.lastname: Haden
authors.forename: Emil
authors.initials: E
authors.lastname: Kheterpal
authors.forename: Naveen
authors.initials: N
authors.lastname: Pokala
mesh_terms: D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000628:therapy*; D015331:Cohort Studies; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011878:Radiotherapy; D012189:Retrospective Studies; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000628:therapy*